Aim: The aim of this study is to determine the prevalence of PCOS among different gynecological disorders at tertiary care hospital of Karachi and to assess the most frequent presenting complaint with associated complications among them. Study Design: Single-centered cross-sectional study. Place and Duration of Study: Gynecological clinic of Karachi at a Tertiary care Hospital during 3rd December 2018 to 29th March 2019. Methodology: Total 335 premenopausal women approached the clinic with different gynecological disorders during the period of four months and 305 patients agreed to participate. The patients were enrolled via convenient sampling technique. After taking the informed consent they were evaluated through clinical interviews, questionnaire, and anthropometric measurements. The diagnosis of PCOS was made by using Rotterdam criteria 2003. Menstrual irregularities were assessed via history. Clinical hyperandrogenism was evaluated by using modified Ferriman–Gallwey scale and Acne Global Grading System. Obesity was calculated through BMI. The Hamilton scale was used to appraise associated psychological disturbances. Results: PCOS was the most prevalent gynecological disorder (55.41%) among women of the premenopausal age. Overall, the most frequent presenting complaint was infertility but age related variations in symptoms showed that young adolescent and adulthood had more menstruation irregularities while, in late adolescent the chief complaint was infertility. Moreover, these patients were either overweight 32% or obese 46.2%. Other associated problems such as anxiety and migraine were more frequent in young adults and juveniles respectively. Conclusion: PCOS is the most common gynecological problem in our region. These women usually presents with altered complains that influence their physiological and psychological health which in turn effects the quality of life.
Background: When there are high demands besides less resources, a person experiences a feeling of fear that is known as “Stress”. Students of professional schools/colleges and universities are encounter more stress than the general population as they are in a transitory phase from adolescence to adulthood. It has been highlighted that medical education has greater association with stress. There are three examination systems that are been followed by medical colleges of Pakistan (modular, semester and annual systems). However, to the best of our knowledge, no data is available to show the association of stress with current examination systems in our country. Aims: The objectives of our study were to find out the association of stress with different examination systems and to identify the frequency of stress causing and coping factors adopted by 1st, 2nd and 3rd year medical students studying in colleges having different examination systems i.e. modular, semester and annual. Study Design: Comparative cross-sectional study. Place & Duration of Study: This study was conducted from December 2018 to April 2019 in three medical colleges of Sindh having above mentioned examination systems. Study Population: Medical students of 1st 2nd and 3rd year. Methodology: To assess depression, anxiety and stress among study population, DASS Scale was used. To identify the stress causing and coping factors in the students Likert scale based proforma with 19 factors were given to the selected participants Results: There was no significant association of examination system with depression, anxiety and stress, however various stress causing and coping factors were found significant in altering medical student`s life. Conclusion: According to our study, the frequency of stress in the medial students has no association with the examination systems (modular, semester and annual), currently followed by the medical colleges in Sindh, Pakistan.
Hepatocellular carcinoma also known as hepatoma is considered as the most common type of primary liver malignancy and is the leading cause of death worldwide. The incidence and mortality is still on the rise despite the drastic progress in early screening tools and new advancements in diagnosis and treatment. For the patients presenting with advanced disease, Sorafenib is the only approved drug, however the treatment outcome of metastatic cancer is still unsatisfactory with median overall survival below 15 months. Over the past few years great progress has been achieved in anticancer therapy, but development of resistance and unavoidable side effects have weakened these attainments. Keeping in view this stern condition, a number of drugs with novel antitumor mechanisms are under investigations including antimicrobials which have been shown to possess anti-inflammatory, immunomodulatory and cytotoxic effects. In this regard, both conventional and novel antimicrobials are being studied to explore their anticancer potential along with underlying mechanisms which may render them as effective anticancer drugs in near future. Moreover, the new approach of drug repurposing is also being encouraged especially in cancers in order to reduce cost and limit adverse effects. The purpose of this review is to provide Zehra et al.; JAMMR,30 (7): 1-8, 2019; Article no.JAMMR.50951 Review Article
Approximately 3% of the world population has been known to be infected with HCV. Hepatitis C virus is a major etiological factor behind the development of liver diseases such as cirrhosis and hepatocellular carcinoma. Interferon-based therapy has remained as the mainstay treatment for HCV for decades. Owing to the unavoidable side effects of interferon, direct-acting antivirals (DAAs) have been approved recently for the treatment of HCV-infected patient. These drugs have brought revolution in the management of HCV because of their favorable side effects profiles and enhanced rates of sustained virological response. We conducted a questionnaire-based survey study to assess the knowledge and current practices among specialists and senior post graduate trainees regarding treatment of HCV with DAAs. The questionnaire was based on latest WHO guidelines for treating HCV. The results obtained were collected and tabulated. Majority (95%) of physicians were between the age of 21-30 years and mostly (69.6%) were females. Almost three fourth of the practitioners were aware of direct-acting antiviral agents (DAAs) and 70.2% agreed that they reduce the duration of treatment along with low bill burden along with lesser side effects. In this study, we could see that the participants’ knowledge and practices regarding use of DAAs, preference over interferon therapy and recommended combinations for different age groups was appreciable, however there is still a gap of knowledge among doctors regarding treatment of HCV with DAAs which needs to be filled with the help of proper health educational programs and training.
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